tbuckley/cabot-search huggingface dataset:
Letter to the editor: Screening for fatty liver disease and fibrosis in the elderly population: A call for action
Authors: Jie Li, Mindie H. Nguyen
Journal: Hepatology (2022)

To the editor, We read with interest the paper by van Kleef et al.1 on the impact of fatty liver (FL) disease on mortality in the elderly population. The study concluded that FL disease was not a risk factor for cancer‐related, cerebro‐cardiovascular, or all‐cause mortality in individuals aged ≥65 years. Thus, the authors suggested that screening for FL disease and/or fibrosis is unlikely to improve outcomes among the elderly population. However, prior study has suggested that all NAFLD histological stages are associated with significantly increased overall mortality, and this risk increases progressively with worsening NAFLD histology.2 In fact, overall mortality in patients with NAFLD with advanced fibrosis was significantly higher than patients without NAFLD, but not patients with NAFLD without advanced fibrosis. NAFLD with advanced fibrosis (but not those without) is an independent predictor for mortality in patients with NAFLD.3 Therefore, NAFLD with advanced fibrosis was a risk factor for increased mortality, but not NAFLD per se. Additionally, only 12% of the steatosis cohort had fibrosis in this study, and the median follow‐up time was only 6.9 years, so the lack of association between fibrosis and mortality may be due to the lack of sample size and relatively short follow‐up time. In addition, the prevalence of diabetes in this cohort is lower (18.0%) than expected for people with NAFLD, whereas the presence of diabetes in the setting of NAFLD is known to significantly increase the risk of cardiovascular disease (CVD), all‐cause, and CVD mortality compared with nondiabetic NAFLD.4 Therefore, work should continue to identify people who are most at risk for advanced fibrosis. Accordingly, current guidelines recommend that patients with NAFLD should undergo risk stratification according to the presence or absence of significant fibrosis. Therefore, the current study results should be interpreted with caution. The impact of FL disease and/or fibrosis on the mortality in the elderly population requires further investigation. Finally, we would like to congratulate van Kleef and colleagues'1 laudable effort to address this very clinically relevant medical condition because screening for NAFLD in a population with age >50 years is currently recommended and should be adhered to.5
The tumour immune microenvironment and microbiome of pancreatic intraductal papillary mucinous neoplasms
Authors: Tommaso Pollini, Volcan Adsay, Gabriele Capurso, Marco Dal Molin, Irene Esposito, Ralph Hruban, Claudio Luchini, Laura Maggino, Hanno Matthaei, Giovanni Marchegiani, Aldo Scarpa, Laura D Wood, Claudio Bassi, Roberto Salvia, Mari Mino-Kenudson, Ajay V Maker
Journal: The Lancet. Gastroenterology & hepatology (2022)
Accuracy, Feasibility, and Clinical Impact of Prospective Bayesian Pharmacokinetically Guided Dosing of Cyclophosphamide, Thiotepa, and Carboplatin in High-Dose Chemotherapy
Authors: Milly E. de Jonge, Alwin D.R. Huitema, Annemarie C. Tukker, Selma M. van Dam, Sjoerd Rodenhuis, Jos H. Beijnen
Journal: Clinical Cancer Research (2005)

Abstract Purpose: Relationships between toxicity and pharmacokinetics have been shown for cyclophosphamide, thiotepa, and carboplatin (CTC) in high-dose chemotherapy. We prospectively evaluated whether variability in exposure to CTC and their activated metabolites can be decreased with pharmacokinetically guided dose administration and evaluated its clinical effect. Experimental Design: Patients received multiple 4-day courses of cyclophosphamide (1,000–1,500 mg/m2/d), thiotepa (80–120 mg/m2/d), and carbop latin (area under the plasma concentration-time curve 3.3–5 mg × min/mL/d). Doses were adapted on day 3 based on pharmacokinetic analyses of cyclophosphamide, 4-hydroxycyclophosphamide, thiotepa, tepa, and carboplatin done on day 1 using a Bayesian algorithm. Doses were also adjusted before and during second and third courses. Observed toxicity was compared with that in patients receiving standard dose CTC (n = 43). Results: A total of 46 patients (108 courses) were included. For cyclophosphamide, thiotepa, and carboplatin, a total of 39, 58, and 65 dose adaptations were done within courses and 17, 40, and 43 before courses. The precision within which the target exposure was reached improved compared with no adaptation, especially after within-course adaptations (precision for cyclophosphamide, thiotepa, and carboplatin is 19%, 16%, and 13%, respectively); &amp;gt;85% led to an exposure within ±25% of the target compared with 60% without dose adjustments. Toxicity was similar to that in a reference population, although the incidence of veno-occlusive disease was reduced. Conclusions: Bayesian pharmacokinetically guided dosing for CTC was feasible and led to a marked reduction in variability of exposure.
Elevated Cerebrospinal Fluid Substance P Concentrations in Posttraumatic Stress Disorder and Major Depression
Authors: Thomas D Geracioti, Linda L Carpenter, Michael J Owens, Dewleen G Baker, Nosakhare N Ekhator, Paul S Horn, Jeffrey R Strawn, Gerard Sanacora, Becky Kinkead, Lawrence H Price, Charles B Nemeroff
Journal: American Journal of Psychiatry (2006)

Objective: The authors tested the hypothesis that concentrations of the pain-transmitting neuropeptide substance P are elevated in the CSF of patients with major depression or posttraumatic stress disorder (PTSD), which have overlapping symptoms. The authors also sought to determine if CNS substance P concentrations change on provocation of symptoms in PTSD patients. Method: The authors measured CSF substance P concentrations in medication-free patients with either major depression or PTSD and in healthy comparison subjects. Next, using a within-subject, crossover design, the authors sampled CSF for 6 hours through an indwelling subarachnoid catheter in PTSD patients before, during, and after exposure to a 60-minute traumatic or neutral videotape stimulus. Results: Both depressed and PTSD patients had significantly elevated basal CSF substance P concentrations. In the challenge study, marked increases in CSF substance P concentrations were found only after precipitation of PTSD symptoms. CSF substance P concentrations increased by 169% and 90.6% of baseline levels at 10 and 70 minutes, respectively, after the start of the traumatic videotape but changed by only 1.1% and –8.1% of baseline levels 10 and 70 minutes after the start of the neutral videotape. Conclusions: These results suggest that elevated CNS substance P concentrations are involved in both major depression and PTSD. The marked increase in CSF substance P concentrations during and after the symptom-provoking stimulus, but not after the neutral stimulus, implicates CNS release of substance P in the mechanism of acute PTSD symptoms. These data also reveal that CNS substance P responds acutely to psychological stress in humans.
CURRENT MEDICAL LITERATURE.
Journal: JAMA (1899)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Renal Failure, Uncontrollable Thirst, and Hyperreninemia
Authors: Philip W. Rogers
Journal: JAMA (1973)

A patient having long-term hemodialysis with uncontrollable thirst, persistent hyponatremia, and expanded extracellular volume was found to have hyperreninemia before and after hemodialysis. The clinical course of this patient and a similar one from the literature confirm previous investigative studies that suggest that elevated levels of circulating renin (angiotensin) may directly stimulate the thirst center of the hypothalamus. Bilateral nephrectomy in both patients resulted in the dramatic cessation of thirst.
Spatiotemporally controllable diphtherin transgene system and neoantigen immunotherapy
Authors: Muye He, Yuji Sun, Yi Cheng, Jie Wang, Miao Zhang, Rui Sun, Xinyu Hou, Jiajun Xu, Hai He, Hongtao Wang, Zeting Yuan, Minbo Lan, Yuzheng Zhao, Yi Yang, Xianjun Chen, Feng Gao
Journal: Journal of Controlled Release (2023)
Opinion Leaders vs Audit and Feedback to Implement Practice Guidelines
Authors: Jonathan Lomas
Journal: JAMA (1991)

A randomized controlled trial with 76 physicians in 16 community hospitals evaluated audit and feedback and local opinion leader education as methods of encouraging compliance with a guideline for the management of women with a previous cesarean section. The guideline recommended clinical actions to increase trial of labor and vaginal birth rates. Charts for all 3552 cases in the study groups were audited. After 24 months the trial of labor and vaginal birth rates in the audit and feedback group were no different from those in the control group, but rates were 46% and 85% higher, respectively, among physicians educated by an opinion leader. Duration of hospital stay was lower in the opinion leader education group than in the other two groups. The overall cesarean section rate was reduced only in the opinion leader education group. There were no adverse clinical outcomes attributable to the interventions. The use of opinion leaders improved the quality of care. (<i>JAMA</i>. 1991;265:2202-2207)
Sporadic duodenal adenoma is associated with colorectal neoplasia
Authors: M A Murray
Journal: Gut (2004)

<b>Objective:</b> The objective of this study was to assess the association between colorectal neoplasia and sporadic duodenal adenoma. <b>Methods:</b> A retrospective case control study was conducted using the databases of two major teaching hospitals in Western Australia. The frequency of colorectal neoplasia in patients with sporadic duodenal adenomas was compared with that in a control group of patients presenting for endoscopies. The frequency of colorectal cancer in duodenal adenoma patients was also compared with the population incidence. <b>Results:</b> Of 56 sporadic duodenal adenoma patients, 34 (61%) had been colonoscoped. When comparing the findings between patients with sporadic duodenal adenoma and an endoscoped control group, all colorectal neoplasias were significantly more common in the duodenal adenoma group (56% <i>v</i> 33%; odds ratio (OR) 2.4 (95% confidence intervals (CI) 1.1–5.4)). Although finding either advanced colorectal adenoma or cancer was also more common in duodenal adenoma patients (38% <i>v</i> 19%; OR 2.3 (95% CI 1.0–5.2)), as was finding colorectal cancer alone (21% <i>v</i> 8%; OR 3.0 (95% CI 1.0–9.1)), the results were not statistically significant. However, the incidence of colorectal cancer was much greater in duodenal adenoma patients than in the population (p&lt;0.001). <b>Conclusions:</b> Sporadic duodenal adenoma has a clinically important association with colorectal neoplasia. Thus patients with duodenal adenomas should undergo colonoscopy to detect colorectal neoplasia.
Interplay of ADHD Polygenic Liability With Birth-Related, Somatic, and Psychosocial Factors in ADHD: A Nationwide Study
Authors: Isabell Brikell, Theresa Wimberley, Clara Albiñana, Bjarni Jóhann Vilhjálmsson, Esben Agerbo, Anders D. Børglum, Ditte Demontis, Andrew J. Schork, Sonja LaBianca, Thomas Werge, David M. Hougaard, Merete Nordentoft, Ole Mors, Preben Bo Mortensen, Liselotte Vogdrup Petersen, Søren Dalsgaard
Journal: American Journal of Psychiatry (2022)

Attention deficit hyperactivity disorder (ADHD) is a multifactorial neurodevelopmental disorder, yet the interplay between ADHD polygenic risk scores (PRSs) and other risk factors remains relatively unexplored. The authors investigated associations, confounding, and interactions of ADHD PRS with birth-related, somatic, and psychosocial factors previously associated with ADHD.Participants included a random general population sample (N=21,578) and individuals diagnosed with ADHD (N=13,697) from the genotyped Danish iPSYCH2012 case cohort, born between 1981 and 2005. The authors derived ADHD PRSs and identified 24 factors previously associated with ADHD using national registers. Logistic regression was used to estimate associations of ADHD PRS with each risk factor in the general population. Cox models were used to evaluate confounding of risk factor associations with ADHD diagnosis by ADHD PRS and parental psychiatric history, and interactions between ADHD PRS and each risk factor.ADHD PRS was associated with 12 of 24 risk factors (odds ratio range, 1.03-1.30), namely, small gestational age, infections, traumatic brain injury, and most psychosocial risk factors. Nineteen risk factors were associated with ADHD diagnosis (odds ratio range, 1.20-3.68), and adjusting for ADHD PRS and parental psychiatric history led to only minor attenuations. Only the interaction between ADHD PRS and maternal autoimmune disease survived correction for multiple testing.Higher ADHD PRS in the general population is associated with small increases in risk for certain birth-related and somatic ADHD risk factors, and broadly to psychosocial adversity. Evidence of gene-environment interaction was limited, as was confounding by ADHD PRS and family psychiatric history on ADHD risk factor associations. This suggests that the majority of the investigated ADHD risk factors act largely independently of current ADHD PRS to increase risk of ADHD.
Total Hip and Total Knee Replacement
Authors: William H. Harris, Clement B. Sledge
Journal: New England Journal of Medicine (1990)

THE indications for and benefits and limitations of modern total hip replacement have been well defined by the years of experience since the first operation in 1962.1 The operation, which is by far the most successful surgery for patients with advanced osteoarthritis and rheumatoid arthritis of the hip, is now performed an estimated 120,000 times a year in North America.Total hip replacement, in contrast to other major hip surgery, including hip fusion, osteotomy, and cup arthroplasty, is an entirely biomechanical rather than biologic solution to severe arthritis of the hip. The femoral head and part of the femoral neck . . .
Recombinant Human DNase Inhalation in Normal Subjects and Patients With Cystic Fibrosis
Authors: Moira L. Aitken
Journal: JAMA (1992)

<h3>Objective.</h3> —To evaluate the safety of recombinant human DNase (rhDNase) in normal subjects and in patients with cystic fibrosis. <h3>Design.</h3> —Nonrandomized trial in which individuals inhaled rhDNase three times a day Monday through Friday on two consecutive weeks. <h3>Setting.</h3> —The study was performed in the Clinical Research Center at the University of Washington, Seattle. Patients were recruited from the Cystic Fibrosis Center at the University of Washington. <h3>Subjects and Patients.</h3> —Twelve normal subjects and 14 patients with cystic fibrosis were studied (12 patients completed the protocol). The subjects and patients had to be aged 18 to 65 years and have a negative pregnancy test, if female. The normal subjects had to have a normal chest roentgenogram, be nonsmokers, and have normal pulmonary function testing. The patients with cystic fibrosis had to have a forced vital capacity greater than 40% predicted normal and have no recent exacerbation (within 2 weeks) of their lung infection or change in their medication. <h3>Interventions.</h3> —The study design was a repetitive dose escalation of aerosolized rhDNase. The subjects inhaled rhDNase three times a day, Monday through Friday, on 2 consecutive weeks and were rechallenged with a single dose 21 days after the last dose. Spirometry was measured before and 30 minutes after every rhDNase dose. <h3>Main Outcome Measures.</h3> —Pulmonary function testing, serum DNase concentrations, and anti-DNase antibodies. Secondary outcome measures were dyspnea score and quantitative bacterial culture. <h3>Main Results.</h3> —Inhalation of rhDNase was well tolerated by all persons. There were no serious adverse reactions, and no allergic reactions were observed, even on rechallenge. No individual developed rhDNase antibodies. Improvement in both lung function and dyspnea score was observed in the adults with cystic fibrosis. Forced vital capacity was 3.2±0.3 L (mean±SE) on day 1 and was 3.5±0.3 L on day 12. Forced expiratory volume in 1 second was 2.1 ±0.2 L (mean±SE) on day 1 and was 2.3±0.3 L on day 12. <h3>Conclusions.</h3> —Aerosolized rhDNase appears safe in normal subjects and in adults with cystic fibrosis and may improve lung function with short-term therapy. (<i>JAMA</i>. 1992;267:1947-1951)
Ascorbic Acid and the Common Cold
Authors: Michael H. M. Dykes
Journal: JAMA (1975)

We reviewed the clinical data relating to the efficacy and safety of pharmacologic doses of ascorbic acid in the prevention and treatment of the common cold. Although one study tentatively supports the hypothesis that such doses of ascorbic acid may be efficacious, a second study by the same group did not confirm the significant findings, and no clear, reproducible pattern of efficacy has emerged from the review of all the evidence. Similarly, there is currently little adequate evidence on either the presence or the absence of serious adverse reactions to such doses of ascorbic acid, although many such reactions have been hypothesized. The unrestricted use of ascorbic acid for these purposes cannot be advocated on the basis of the evidence currently available. (<i>JAMA</i>231:1073-1079, 1975)
Surgical Recovery of Schistosomes From the Portal Blood
Authors: Edward I. Goldsmith
Journal: JAMA (1967)

A new surgical approach to the treatment of hepatosplenic schistosomiasis was used in three patients, with highly encouraging early results. Large numbers of adult schistosomes were removed from the portal blood by extracorporeal filtration following mobilization of the worms from the venules of the intestinal tract with a single dose of antimony potassium tartrate.
Facilitating the Transitions of Adolescence
Authors: David A. Hamburg
Journal: JAMA (1987)

MOST children in affluent countries grow up healthy and reasonably happy. Yet even in the favored sectors of such societies, there is much perplexity about prospects for the future of children, especially adolescents. Casualties among the young are, of course, caused by disease, but even more by disabling injuries, ignorance and prejudice, failure and humiliation, hatred and violence. Efforts on behalf of adolescents have rarely been equal in scale, quality, or approach to the magnitude of the challenge. Although useful work is being done, there is no broadly integrative center for taking stock of existing approaches and stimulating new ones, no one institution where the different sectors of American society come together to pool their efforts in this field. Carnegie Corporation of New York, therefore, has launched a new venture—the Council on Adolescent Development. The council is composed of national leaders from diverse sectors (Table). Its goal is to foster
The University Group Diabetes Program
Authors: Stanley Schor
Journal: JAMA (1971)

When a statistician or a researcher in any field designs a study, there are many concepts which he must clarify in his own mind before the study is started. He must define his problem, his target population, and his statistical unit, decide on how he is going to take a sample and what he is going to do with it when he gets it, realize what problems can arise because of the manner in which the sample is selected, and he must decide how to collect, tabulate, and analyze the data, and what kinds of conclusions he could draw. When a statistician evaluates a study done by someone else, he obviously must look at the same concepts to see whether the conclusions drawn follow logically from what was done in terms of the manner in which these concepts were defined. I would like to take the University Group Diabetes Program
The Navigation Guide—Evidence-Based Medicine Meets Environmental Health: Systematic Review of Nonhuman Evidence for PFOA Effects on Fetal Growth
Authors: Erica Koustas, Juleen Lam, Patrice Sutton, Paula I. Johnson, Dylan S. Atchley, Saunak Sen, Karen A. Robinson, Daniel A. Axelrad, Tracey J. Woodruff
Journal: Environmental Health Perspectives (2014)

Background: In contrast to current methods of expert-based narrative review, the Navigation Guide is a systematic and transparent method for synthesizing environmental health research from multiple evidence streams. The Navigation Guide was developed to effectively and efficiently translate the available scientific evidence into timely prevention-oriented action.Objectives: We applied the Navigation Guide systematic review method to answer the question "Does fetal developmental exposure to perfluorooctanoic acid (PFOA) or its salts affect fetal growth in animals ?" and to rate the strength of the experimental animal evidence.Methods: We conducted a comprehensive search of the literature, applied prespecified criteria to the search results to identify relevant studies, extracted data from studies, obtained additional information from study authors, conducted meta-analyses, and rated the overall quality and strength of the evidence.Results: Twenty-one studies met the inclusion criteria. From the meta-analysis of eight mouse gavage data sets, we estimated that exposure of pregnant mice to increasing concentrations of PFOA was associated with a change in mean pup birth weight of –0.023 g (95% CI: –0.029, –0.016) per 1-unit increase in dose (milligrams per kilogram body weight per day). The evidence, consisting of 15 mammalian and 6 nonmammalian studies, was rated as "moderate" and "low" quality, respectively.Conclusion: Based on this first application of the Navigation Guide methodology, we found sufficient evidence that fetal developmental exposure to PFOA reduces fetal growth in animals.Citation: Koustas E, Lam J, Sutton P, Johnson PI, Atchley DS, Sen S, Robinson KA, Axelrad DA, Woodruff TJ. 2014. The Navigation Guide—evidence-based medicine meets environmental health: systematic review of nonhuman evidence for PFOA effects on fetal growth. Environ Health Perspect 122:1015–1027; http://dx.doi.org/10.1289/ehp.1307177